RESUMEN

PURPOSE: In the past years the significance of white matter hyperintensities (WMH) has gained raising attention because it is considered a marker of severity of different pathologies. Another condition that in the last years has been assessed in the neuroradiology field is cerebral microbleeds (CMB). The purpose of this work was to evaluate the association between the volume of WMH and the presence and characteristics of CMB. MATERIAL AND METHODS: Sixty-five consecutive (males 45; median age 70) subjects were retrospectively analyzed with a 1.5 Tesla scanner. WMH volume was quantified with a semi-automated procedure considering the FLAIR MR sequences whereas the CMB were studied with the SWI technique and CMBs were classified as absent (grade 1), mild (grade 2; total number of CMBs: 1-2), moderate (grade 3; total number of CMBs: 3-10), and severe (grade 4; total number of CMBs: >10). Moreover, overall number of CMBs and the maximum diameter were registered. RESULTS: Prevalence of CMBs was 30.76% whereas WMH 81.5%. Mann-Whitney test showed a statistically significant difference in WMH volume between subjects with and without CMBs (p < 0.001). Pearson analysis showed significant correlation between CMB grade, number and maximum diameter and WMH. The better ROC area under the curve (Az) was obtained by the hemisphere volume with a 0.828 (95% CI from 0.752 to 0,888; SD = 0.0427; p value = 0.001). The only parameters that showed a statistically significant association in the logistic regression analysis were Hemisphere volume of WMH (p = 0.001) and Cholesterol LDL (p = 0.0292). CONCLUSION: In conclusion, the results of this study suggest the presence of a significant correlation between CMBs and volume of WMH. No differences were found between the different vascular territories.

Asunto(s)

Hemorragia Cerebral/diagnóstico por imagen , Leucoencefalopatías/diagnóstico por imagen , Imagen por Resonancia Magnética , Sustancia Blanca/diagnóstico por imagen , Anciano , Anciano de 80 o más Años , Hemorragia Cerebral/epidemiología , Femenino , Humanos , Hipertensión/epidemiología , Leucoencefalopatías/epidemiología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Prevalencia , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo

RESUMEN

Objective To observe the high-resolution magnetic resonance imaging (HR-MRI) features of proximal portion of middle cerebral artery (M1 portion) in patients with moyamoya angiopathy (MMA).Methods Forty-six MMA patients and 12 health volunteers,collected in our hospital from January 2014 to September 2015,were chosen in our study;these subjects were performed three dimensional time of flight magnetic resonance angiography (3D-TOF-MRA) and HR-MRI.The quantitative measurements were conducted retrospectively at the minimum cross-sectional area of vessel and maximum thickness of wall;the morphological changes of the vessel wall of the M1 portion and enhancement or not of wall were evaluated.Moreover,general clinical data and vascular risk factors of all patients were evaluated.Results The minimum cross-sectional area of volunteers was (13.71 ± 2.510) mm2,and the maximum thickness was (0.631±0.203) mm;the minimum cross-sectional area of patients with MMA was (2.700±1.511) mm2,remodeling index was (0.209±0.136),and the maximum thickness was (1.078±0.375) mm.Eccentric thickening was noted in 30.4％ patients (14/46),concentric thickening in 69.6％ patients (32/46).Wall non-enhancement was noted in 45.7％ patients (21/46) and wall enhancement in 54.3％ patients (25/46).Eccentric thickening patients had significantly elder age,higher maximum thickness of wall and carotid atherosclerosis rate than concentric thickening patients (P＜0.05).Multivariate Logistic regression showed that carotid atherosclerosis were independently associated with wall eccentric thickening (OR=4.986,95％CI:1.263-36046,P=0.026).Wall enhancement patients had significantly higher maximum thickness of wall and hypertension level than the wall non-enhancement patients (P＜0.05).Logistic regression showed that hypertension was independently associated with wall enhancement (OR=1 1.764,95％CI:2.081-66.51,P=0.005).Hypertension and carotid atherosclerosis were positively related to the wall thickness (r=0.401,P=0.008;r=0.415,P=0.004).Themaximum thickness was significantly higher in hypertension group than that in normal blood pressure group ([1.234±0.4329] mm vs.[0.936±0.2455] mm,P=0.008).Conclusions M1 portion commonly shows concentric thickening,or eccentric thickening when MMA comorbid with atherosclerosis and negative remodeling in MMA patients on HR-MRI.Wall enhancement is associated with wall thickening,and hypertension is an important factor in the wall thickening.